The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 5/11/2015 TFt BUILDING PERMIT 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N01 Date Received r D0 Date Issued: I C SSAC HU5�4 IMPORTANT: Applicant must complete all items on this pa M-- LOCA TION Print PROPERTY PtRT' Y OWNER C%, ------777, Pri n PARCEL: (n," istoncDii ,Hi strict yes ZONING,DISTR'ICT: h'op,Village, r n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential [I New Building 2, ne family 11 Addition 0 Two or more family 11 Industrial 2--A—iteration No. of units: 11 Commercial [I Repair, replacement F1 Assessory Bldg 11 Others: 11 Demolition 11 Other ❑ --P p,IG0 Well o,Fi66dpiain 1Wetlands at' hie<_d'bt t WateriSewer I-- FR_4Mr, rJ e P( Ukl&tj 1-c-fif CA""" vrwirg 10 -I'C> rZV-1(f4(d;t- ftkf,�. (91..tQW f 10LAIP Identification Please Type or Print Clearly) OWNER: Name: 4Y LOW Phone: 91� F-V q3 Address: l S rt A0 G 15- V TT tJ.AN 0 oc/vfA 5bbNtkACTOR Name:' Phone P e.,,.,,. Supervisor's Const i'on, Jc ense _ Date '- '- a3. Homefrn777 Orovement License: E '7 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED qN$125.00 PER S.F. Total Project Cost: FEE: Check No.: /j- I Receipt No.: NOTE: Persons contracting with unregi ered contractors do not have access-Kthe guarantyfund 0\'_Signature of Agent/i W Signatureof contractor tkORTH . - �.. , Town of ® Andover ® - zh 6 o SAH , h ver, Mass, coc HIc HcwKK �1' SRATED Cl U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ....... ... ............................................. . ............................................... BUILDING INSPECTOR . . Foundation .. has permission to erect .......................... buildings on ..5........ ................. .... ........ ...... ....... . Rough tobe occupied as ......... ....... .. ... ..®...... ....1..... ........................................:.............................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 OTHS ELECTRICAL INSPECTOR LESS C ST T Rough Service .............. .... ........................:............................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy BuRough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved y the Building Inspector. Burner Street No. Smoke Det. F R A N K 11 FRANK HOWARD CARPENTER &BUILDER HOWARD Homey mer: Anne (<", Barry Low 15 T\/l 1(1,11 ese.x Ave. North, Ando\,er,Ma April 25,2014 19784VO-8193 c Builder: Frank 1 'o\\,,ir(l Construction LLC 512A 'Giii cit Box 10 1- '.N,It 0211921 978-2,,', -230 c 978-3 '.-7601 fax &bus S436�' 185 HIC : 7191 cxp.8/19,/16 CSL I ;.') cxp9/3/16 Contt Seco "loor Rath Remodel: Plum's ", 11'�1 a i-cs&Door hardware to be Brushed Nickel, Fixture list from Peabody Supl)!.,, \Lig." 1, 2014 includes towel bars and accessories Install grab bars supplied by own C Perini 'Or 1�!mnbing,electrical, building Deme ,is I.I i Bath to studs Opei, flom to reconstruct plumbing, location of sink&toilet to be moved to fit new layo�11 Inst.i' I i I bing for one shower, one Lav, one toilet(reuse existing toilet, , Fixture list l r J'c� dy Supply Aug. 2014) 512A MAIN STREET, BOXFORD,MASSACHUSETTS 01921 VOICE: 978.352.7604 FAX: 978.352.7604 Insta ,tie nCw Andersen awning window,complete interior trim & exterior siding size k )e deicrmined at rough framing stage Instal! iew too kick heater at bottom of vanity Elect, .,al :Install one recessed light over shower,install one Nutone fan& lite unit veni o e,\:I,,rior,Instal I homeowner supplied light at mirror,install one gfi receptacle Inspc( framing for straight,plumb, adjust accordingly Insta'' new insulation exterior to walls( interior walls for sound , inspect ceiling insu'. )n, add new if needed Exi.,;'' dom- to stay Inst,, .1uebo.ird and pLister to areas not recieveing tile Insa 1/2" cci Hent board as underlayment under all tile work except shower floor (mu; . 'b) Con et fniming for one approx 32"x 56" copper pan supplied by us Inst: -cramic tile to shower floor ,walls and ceiling.Install tile to Bath floor,..., Inst: cramic the behind toilet ( no other wall tile) Cer: , tilc :C'o\v 4.00 /ft., Bull nose and deco tiles are Additional cost Dia iI instill is add it1onal cost labor and waste Sul-- ins!:iil granitc top for vanity, same granite to be used for shower seat, thrc I to sl,,)wer Products from Athena Marble & Granite ,Ward Hill, Ma Inst: �ew trim to door k window I wi �nstruct Vanity. Vanity to be paint grade 3/4 " Birch plywood,maple face frame. V'r 1,:Ivy wo dr:i\,crs , otic on top of the other mounted left or right . determined at site Fra; >s sl;'� Cr door :111mv 1200.00 Ins St. ,A �.�� l 1 .�"15 CJeii :�l ,)rox thmc weeks Prom start 512A MAIN STREET, BoxFORD,MASSACHUSETTS 01921 VOICE: 978.352.7604 FAx: 978.352.7604 Acceptance: The above prices ,specifications and conditions are satisfactory and are hereby accepted You are authorized to do the work as specified. Payment to be made as outlined above. Signature Date Signature Date °` BJNNMOPNM ANDERSEN REPRESENTATIVE dads.patio Mdersen' IV 3 ......... ................. DATE: JOB: A,v p(-foe 0/i CY ...................... ................... The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 w _ www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ApUl cant Information Please Print Legibly Name(Business/Organization/Individual): Y �A (< „dP/4+S.P Address: L , A MIS.01. 2 City/State/Zip: a'� l C Phone #: L-18 u orf Are you an employer? Check the appropriate box• Type of project(required): 4• am a general contractor and I 6 E]New construction 1.El I a m a employer with * have hired the sub-contractors employees(full and/or part-time). 7• emodeling listed on the attached sheet. 2.❑ I am a sole proprietor or partner- These sub-contractors have g. [] Demolition ship and have no employees employees and have workers' working for me in any capacity. comp. insurance. 9. F1 Building addition [No workers' comp. insurance 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ officers have exercised their ll.E]Plumbing repairs or additions 3. I a homeowner doing all work right of exemption per MGL myself. [No workers' comp. 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: k C 6W4- Z Policy#or Self-ins.Lic.#: t° Expiration Date: Job Site Address: 5'/Y,$ Cis lCity/State/Zip: l Ar�t)cxs'+ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a.STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for-insurance covera e verification. I do hereby certify under thepains anddpenalties ofperjury that the information provided above is true and correct. Signature: Glt Date: — Phone rdnly. Do not write in this area, to be completed by city or town official n: Permit/License#ssugority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: RATE(MMIDDIYYYY) ILITY INSURANCE ACORQCERTIFICATE OF LIAS 14/23/2014 M TNI$CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND ICpNP+ERS NO RIC3HTS UPON THE CERTIFICATE "OLDEfd.THIS CERTIFICATE DOE$NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED B'V`THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT- If the certi II atfa holder is an ADDITf NAL INSURBD,the POB5(ies)must I endorsed. if SUBR ATO IB WAI Cl,subs to the terms and conditions of the pollcy,certain policies may rmquira an endorsement, A staWmant on this certificate does not confer rights t0 the certlf late holder in lieu of such endorsoment(s). PRODUCER p Emi l y �OSt+el t o FHONE 978.374. 352 alc,No:978.521.5127 COSTELLO INSURANCE AGENCY A1C Na Ext 2 South Kimball St. A� -E-MAIL ecb itellODCO$te110insurance.COM PO goo 524$ INSURER(S)AFFORDING GOVERAOr NAIL# Bradford, MA 01835 INSURERA: Na mutual ens. C+a 14788 INSURED Frank Howard (Carpenter INSURER B: Acadia. 51ZA Main St. tweuR��Q: Boxford, MA 01921 W3URERG: INSURERS: INSURER F COVERAGES CERTIFICATE NUMBER-2014 REVISION NUMBER: TH-51'U18FTO CERTIFY THAT THE POU IE INSURANCE LISTED BELOW HAVE BEEN ISSUED TO T NSURED NAMED ABOVE FOR THE POLI Y ERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPE OF INSURANCE (NSR wVD pow"NUMBER MWDpY Y MMIDDNYYY LIMITS GaNBRALLAMLITY MPM0078 0912'212014 0912212098 EACHOCCURRENOE S 1,000,004 X COMMERCIAL GENERAL LIABILITY PREMISE8(EaocouLeK.A $ $00,000 CLAIMS-MADE I X i OCCUR MED EXP(AIIY ane parson) 10 000 A PERBONALRADV INJURY $ 1 000 000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMITAPPLIE9 PER- 7 ER PRODUOTS,COMPIOP AGG $ 2.000,004 POLIC`7 MT LOC $ $ JEvT AUTOMOBILE LIABILITY M9M0478 0719412014 0711412015 Ea _ BODILY INJURY(Pet peta0n) $ 250 000 ANY AUTO A ALL O4VN>t7 SAu�NO> ULED BODILY INJURY(Peraaident) $ 500f00 AUTOS NQN OWNEDS S 100,010() }`+ NIREDAUTOS AUTOS tRer eM) UMBRELLALIAB EACH OCCURRENCE $ OCCUR E)(C69S L1AEI CLAIMS-MADE AdOREdATE DED RETENTION$ WORK@RBCOMPENSATION WC2()200 834010910912014 001(100'15 TORYLIMI73 ER AND EMPLOYERS'LIABILITY EACW ACCIDENT $ 100,000 {� OFFICERIMEM PRREXUUDE�?EC I� NIA (Mandatory in NH) E.L.DISEASE-IIA EMPLOYEE $ 100 OOU (yaen dory In Under E.L.DISEASE-POLICY LIMIT $ 500J000 ID'MR11090Ne OF OPERATIONS U010W SCRWRION OF QP9RA-n" NS I LCOATIONS I VEHICLE$ (AHach ACORD IOI,AddittOnel Remeft Schedule,tf MOtOSPa00 la regUire CE0J CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 0E CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE D18UV8RED IN ACCORDANCE WITH TIDE POLICY PROVISIONS. RUjiT,5 +±DD REPRESENTATIVE 9$88-2030 ACIORD CO ION.AMnts roservad. ACORD 25(2090105) The ACORD name and logo aro registered marks of ACORD Massachusetts -Department o$Public Safety- Board fO Office of Consumes Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR Boar: cf Building Regulations and Standards egistration: 167191 Type: i Construction Supen-iso x iration. 8/19/2016 LLC License: C"42443 3 FRANK HOWARD CONSTRUCTION LLC FRANK L IiOWA}t`D 512A MAIN ST FRANK HOWARD BOXFORD MA 8192 � 512 A MAIN ST. BOXFORD,MA 01921 Undersecretary � � �ril�`` Expir ion `' Commissioner 09/0312016